Creating Constructive and Supportive Communication with Family and Friends

This post is devoted to a particularly challenging issue—addressing the attitude of your family and friends towards cochlear implantation and the rehabilitation process that follows. Likely your family and friends will support your decision to pursue a cochlear implant and wish you the best possible results in the hopes for a better quality of life. Family and friends can be a great source of support for you during the process. The main message I want to convey in this post is not to underestimate the importance of open communication with the people closest to you regarding the circumstances that led you to cochlear implantation. This will be an opportunity for your family to learn more about your life, and also an important opportunity for you to gain their understanding and constructive support.

Hearing loss is often called the "invisible disability". People with hearing loss may make extraordinary efforts to communicate with typically hearing people. Sometimes they give up the opportunity to fully understand what has been said in order to avoid a situation that they view to be embarrassing. However, if the person with hearing loss shared the responsibility for improving communication with others, (s)he could improve the situation. The "invisible" nature of the impairment puts all the burden on the person with hearing loss.

People with normal hearing, even those who have a close family member who has hearing loss, are not always aware of all the implications and the severity of the communication limitations that hearing impaired people experience. This is especially true when the hearing impaired person has normal speech.

When people who have hearing loss decide to undergo cochlear implantation, the main reason is not necessarily to help their family members and friends to communicate with them. Typically the person pursues a CI primarily for herself and it is critical that the people closest and most important in their lives understand their motives.

People with normal hearing are not aware of how difficult it is for people who have hearing loss to function in difficult acoustic environments or complex communication situations. It is important that you share with your relatives and friends the kinds of environments that are especially difficult for you (e.g., noisy restaurant, outdoors, gym, parties) as well as difficult communication situations (e.g., business meetings, multiple speaker conversations, talking with children or people who have accents). What do you feel in these situations? How do you deal with your difficulties? What could make things easier? What could make it worse? All of these topics should be discussed.

Such dialogue can improve family members’ understanding of your daily challenges. It enables you to share your concerns. Feelings of joy and satisfaction in light of the benefits you derive from the cochlear implant can be shared, even if they are not yet obvious to others. Enhancement of speech reading and the ability to respond to someone who calls your name are two examples of exciting experiences that family and friends are not always aware nor can they appreciate these milestone for you without this kind of sharing of your feelings and experiences.

I want to share a story with you. A woman with a cochlear went on a vacation with her mother and sister. They were eating in a noisy hotel dining room when she heard the waiter who was standing behind her asking them if they wanted an extra drink. She replied to the waiter and then she said excitedly to her mother and sister, "Did you see that? I understood what he said even though he was standing behind me!" Her mother and sister reacted with indifference and she was deeply hurt by their reaction. She explained to me afterwards, "They did not realize how impossible this situation would have been prior to my having received a cochlear implant and they did not understand my feelings of accomplishment."

Another reason to discuss these issues is that many people experience a new world of sound after implantation. Initially some may be challenged by learning to understand speech with competing environmental sounds. Family members and friends can help during this stage by identifying environmental sounds for the new CI recipient. Another auditory challenge is to be able to focus on the most relevant sounds in the presence of other sounds. This is a complex auditory skill that often improves over time. Family members can help by taking steps to minimize the environmental sounds at home (e.g.: turning off noisy appliances, closing doors).

Involving family members in the rehabilitation process may contribute in many positive ways. Family members might join you for your appointments with the cochlear implant team, at lectures, and for meetings with other CI recipients. Family members who consistently attend the rehabilitation and auditory training sessions have a better understanding of the process and may then assist during your home practice sessions. By being part of the process, they will better understand what you are going through and be positioned to support and encourage you as partners in the path you have chosen.

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It has been my experience that sometimes cochlear implantation changes the balance of power in adult relationships. The previously dependent wife is no longer as needy; the once bashful husband now advocates for himself. These changes would seem to be positive but they disrupt the status quo and require sensitivity on the part of family members as new “rules” of communication are established. Clinicians play an important role in helping families navigate these communication changes.

As you mentioned, the process described is indeed evident in many cases. Though it seems like a positive process, it is not a simple one. Changing the level of independence and self-confidence can also open a lot of possibilities that had not been seen before. In one of my next posts I will address the emotional aspects involved in adult CI. The impact on relationships is inevitable. Thank you for pointing out this sensitive and important issue.